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Session 65 Poster Session Antiretroviral Chemotherapy in Resource Limited Settings Session Time: 4:30-6:30 pm Room 4E-F

462-W. Survival of Persons with HIV Disease following Antiretroviral Therapy in Southern India N. Kumarasamy*1, K. Mayer2 , T. Flanigan2, R. Hemalatha1, C. Carpenter2, S. P. Thyagarajan3, and S. Solomon1 1YRG Ctr. for AIDS Res. and Education, Chennai, India; 2Brown Univ., Providence, RI; and 3Univ. of Madras, Chennai, India Background: There are very few reports on the beneficial effects of antiretroviral therapy (ART) from developing countries. Here we report the survival time and adverse effects of persons who received antiretroviral therapy in a clinic-based population in Southern India. Methods: This study was a retrospective analysis of 287 persons with HIV and with CD4 cell count less than 350 cells/muL and being followed up in a tertiary referral HIV care center in Chennai, India between June 1996 and June 2001 for a mean of 155.4/100 person years. The study subjects were divided into 4 groups based on their CD4 cell count and initiation of ART. Group 1: Patients started on ART when the CD4 cell count was less than 200 (n=141); group 2: Patients initiated ART when the CD4 cell was between 200 and 350 (n=35); group 3: Patients with CD4<200 and not on ART (n=72), and group 4: Patients with CD4 between 200 and 350 and not on ART (n=39). Survival analyses were performed to determine mean survival times in patients stratified by baseline CD4 and Kaplan Meir curves were utilized to demonstrate the rates of disease progression. Results: The mean survival of persons who initiated ART when the CD4 cell count < 200 was 46 months (group 1) and the mean survival of persons who initiated ART when the CD4 cell between 200 and 350 was 78 months (group 2) (p<0.001). The mean survival of persons who were not on ART was 27 months in the group 3 and 73 months in the group 4 (p<0.001). 55 (31.3%) individuals reported adverse effects of ART. Among the adverse effects, the predominant one was peripheral neuropathy (21.8%), followed by anemia (16.4%), blue coloration of nails (10.9%), nausea/vomiting (9.1%), hepatitis (7.3%), skin rash (5.5%), and diarrhea (1.8%). Immune reconstitution syndrome was seen in 13 (7.4%) individuals who received ART. Lymphadenitis due to tuberculosis flared up following ART in 12 individuals and 1 had immune recovery vitritis. Conclusions: Antiretroviral therapy in advanced HIV+ patients is beneficial in the developing world but the high co-prevalence of TB must alert clinicians to immune reconstitution syndrome.

©2002 9th Conference on Retroviruses and Opportunistic Infections